Individual
MR. DANIEL C SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1691 N US 23, SUITE 2, E TAWAS, MI 48730
(989) 362-9546
(989) 362-9567
Mailing address
1691 N US 23, SUITE 2, E TAWAS, MI 48730
(989) 362-9546
(989) 362-9567
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003153
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410046393
RAILROAD MEDICARE
MI
01
—
900C510060
BLUE CROSS BLUE SHIELD
MI
01
—
OM89210001
BCBSM MEDICARE ADVANTAGE
MI
Enumeration date
09/28/2006
Last updated
07/07/2011
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